101Careers in CounselingIn this weekly feature, the editors of SpringBoard highlight one career in the health care professions–including a basic description, educational requirements, core competencies/key skills needed, and related web sites and professional organizations where you can find more information!

Counseling the elderly in retirement centers will likely become more common in the near future. With the average life span of people in the United States increasing and with services for the elderly likely to increase, counseling geriatric populations will become more popular. Though figures are hard to come by, my own experience in the counseling field is that the elderly are being underserved by the mental health field. You can expect this to change as the elderly population increases and the demand for services intensifies. Some retirement centers hold classes on academic topics, exercise classes, social outings, and many more activities. Expect counseling services to be added to the list. After all, giving up one’s home, independence, mobility, and so forth and being near the end of life will likely result in depression and a desire to discuss meaning-of-life issues.

Degree Required
Master’s degree.

Issues to Understand
Counseling in a retirement community will be very different from counseling in many other settings. First, the residents of the retirement community are elderly and are not in the stage of planning a career, looking to expand their family, or contemplating preparing for the next 30 years of life. The elderly are likely to be more concerned about their health, family relations, personal autonomy, and end-of-life care. Many elderly in retirement homes would have been separated from their family by long distances, or may be isolated because their family members do not visit them regularly. Depression will be very common, and loneliness is to be expected for many of the residents.

Another issue is that retirement centers will be staffed by nurses, occupational therapists, administrators, certified nurse’s assistants, and other non-counseling professionals, and therefore counselors will need to work to establish good professional relationships with some colleagues who may not understand mental health issues (or may not value them as they value medical issues).

Perhaps the most challenging issue will be that many residents are dying or in serious physical and mental decline. Counselors will watch many of their clients decline and die. Some residents will decline rapidly and die in a short time span, while others may linger for months or even years. It will take a resilient person to provide ongoing services to the elderly in retirement homes.

Best Aspects of the Job
As a college student home for the summer, I spent a summer working as what was then called an “orderly” in a nursing home. The job was physically and emotionally demanding, though I enjoyed the interaction with many of the residents. I found much collective wisdom in the oldest of the residents (the residents who had not slipped into dementia) and looked forward to my daily conversations with those people. I suspect that counselors who choose to work with the elderly in retirement communities would enjoy the challenges of serving the elderly and like the personal connections with a population who have so much life experience.

Challenging Aspects of the Job
The most challenging part of the job is likely to be the emotional difficulty of observing many of your clients decline and die. Many residents will die quickly and with dignity, surrounded by loved ones. But others will die a protracted death, alone and isolated, and in many cases, their minds will have slipped into the throes of dementia long before their actual death. Then there are the residents whose families have abandoned them. These residents are lonely, depressed, angry, and confused as to why their children and grandchildren do not come to visit. (There can be many reasons for why their family does not visit, such as discomfort with retirement communities or unresolved issues with the senior family member.)

Occupational Outlook and Salary
Currently, the Bureau of Labor Statistics does not compile figures for counselors working with the elderly. At present, few counselors are working in retirement homes due to an under-appreciation of mental health services for the elderly and the fact that counselors are still unable to bill Medicare. (Again, Medicare is the last “great” obstacle for counselors to overcome. It is likely that the counseling profession will overcome this obstacle within the next 10 years.) However, readers of this text can be assured that with more people living longer lives, counseling the elderly will be as common as counseling children and adolescents at some point in the future. It is likely that salaries will approximate salaries of counselors in inpatient hospitals (say, a range of $30,000 to $45,000, depending on the years of experience and the funding of the retirement community).